Factors Affecting Healthcare Professionals' Decision-Making Around Parenteral Nutrition in Advanced Cancer: A Systematic Review

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS Journal of Human Nutrition and Dietetics Pub Date : 2025-02-05 DOI:10.1111/jhn.70009

Jennifer McCracken, Sabrina Bajwah, Clare Shaw

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引用次数: 0

Abstract

Background

Many factors beyond clinical guidelines may influence healthcare professionals' (HCPs) decision-making. This systematic review aims to identify the factors that affect HCPs decision-making around parenteral nutrition (PN) in advanced cancer.

Methods

A literature search was conducted by May 2023 via MEDLINE, Embase, PsycINFO, The Cochrane Library, CINAHL, PubMed, Web of Knowledge and PROSPERO. Fourteen additional papers were identified. Two reviewers independently screened all papers with consensus reached on inclusion. Three reviewers conducted quality appraisal independently. Reference checking and citation tracking were completed for all included papers.

Results

Of 458 papers identified, 5 papers met the eligibility criteria (3 online surveys, 2 qualitative studies). All papers were European. Papers were published between 2020 and 2023. Six themes were identified as affecting decision-making: clinical indications, quality of life, hope, the multidisciplinary team, barriers to facilitating home PN and the influence of relatives. Performance status was a commonly considered indicator of suitability for home PN. PN is more common for people with advanced cancer and intestinal failure (IF) in the UK. Barriers to providing PN included unclear clinical indication, colleague objections, lack of local expertise and poor communication between HCPs.

Conclusion

Collaborative working and effective communication are essential between acute services, IF centres and community services to facilitate decision-making around PN in advanced cancer. It is important for HCPs to set realistic expectations. Communication must be sensitive to the patient's values and culture.

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来源期刊

Journal of Human Nutrition and Dietetics 医学-营养学

CiteScore

5.30

自引率

15.20%

发文量

133

审稿时长

6-12 weeks

期刊介绍： Journal of Human Nutrition and Dietetics is an international peer-reviewed journal publishing papers in applied nutrition and dietetics. Papers are therefore welcomed on: - Clinical nutrition and the practice of therapeutic dietetics - Clinical and professional guidelines - Public health nutrition and nutritional epidemiology - Dietary surveys and dietary assessment methodology - Health promotion and intervention studies and their effectiveness - Obesity, weight control and body composition - Research on psychological determinants of healthy and unhealthy eating behaviour. Focus can for example be on attitudes, brain correlates of food reward processing, social influences, impulsivity, cognitive control, cognitive processes, dieting, psychological treatments. - Appetite, Food intake and nutritional status - Nutrigenomics and molecular nutrition - The journal does not publish animal research The journal is published in an online-only format. No printed issue of this title will be produced but authors will still be able to order offprints of their own articles.